We see implant revision cases every week — patients whose previous implant failed and who need someone to identify what went wrong before placing a replacement. Without that diagnosis, the second attempt is at risk of failing the same way.
Full-arch failures (e.g., a failed All-on-4 case) are quoted separately. Written, itemized pricing provided in consultation.
Get a Written Treatment PlanUrgent cases: If your implant has just become loose, fallen out, or shows signs of infection (pain, swelling, pus, fever), you should be seen as soon as possible. Call our office and let us know — we accommodate urgent implant cases ahead of routine appointments.
The core principle in handling a failed implant is this: a second implant placed without understanding why the first one failed has a higher chance of failing too. Implant failure is rarely random. It usually has a specific, identifiable cause — and addressing that cause is what gives the replacement a real chance.
There are five main categories of implant failure, and most cases involve more than one factor. Failure of osseointegration (the bone never fully bonded with the implant), peri-implantitis (infection-related bone loss around the implant), mechanical or prosthetic failure (loose screws, fractured abutments or crowns), bite-force overload, and surgical positioning errors all produce different patterns — and each demands a different response in the replacement plan.
Our job at a failed implant consultation is to figure out which of these factors were at work, what we can do to neutralize them, and only then to plan the replacement.
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Understanding which mode caused your original failure determines what the replacement plan needs to address.
Osseointegration is the process where the implant fuses to the surrounding bone. Failure here means the bone never fully bonded with the implant — sometimes from the start (early failure, within months), sometimes after years of partial integration (late failure). Common contributors include inadequate primary stability at placement, thermal damage during drilling, or loading the implant before integration completed.
This is essentially gum disease around an implant — bacterial infection that destroys the bone supporting the implant. It's the most common cause of implant failure after the first year. Risk factors include inadequate oral hygiene, smoking, uncontrolled diabetes, and failure to receive routine cleanings.
The implant itself is fine, but the components attached to it (the abutment, screw, or crown) fail. This can include loose screws, fractured abutments, or fractured crowns. Often this is fixable without replacing the actual implant.
Implants placed in positions that bear excessive force — particularly single posterior molar implants opposing dense crown work, or implants in patients with severe bruxism — can fail from accumulated mechanical stress.
Implants placed too close to a nerve, sinus, or adjacent tooth, or angled incorrectly, can fail or require removal regardless of the bone or hygiene situation.
When you arrive for a failed implant consultation, we treat it like a forensic investigation. The original implant failed for a reason. Our job is to find that reason before placing anything new.
We start with a thorough history review — when the original implant was placed, by whom, how long it lasted, what symptoms preceded the failure, and what you were told at the time. Records from the original practice are helpful when available. Then comes 3D cone-beam CT imaging — non-negotiable for failed implant cases, because the 3D scan reveals exactly what bone is left, where the failed implant sits, and what’s anatomically possible. 2D X-rays are insufficient.
Only after cause identification do we plan the replacement. The plan addresses the original failure cause — often through bone grafting, modified implant positioning, different implant type, or changes to the prosthetic design.
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Most replacement cases follow this sequence. Specifics vary — particularly in cases where the original failure was prosthetic and the implant itself may be salvageable.
If still present, the failed implant is removed under local anesthesia or IV sedation. Removal is usually straightforward when the implant has lost integration; cases with infection may require additional cleanup of the surrounding tissues.
Once a failed implant is removed, the surrounding bone has typically been compromised. Most replacement cases benefit from bone grafting at the time of removal to rebuild the site for the replacement implant.
3–6 months of healing, depending on the extent of grafting. During this period, you wear a temporary partial denture, flipper, or other interim solution.
The replacement implant is placed using protocols designed to avoid the failure mode of the original. This may include different positioning, different implant type, or modified loading.
After integration of the replacement implant, the final crown or bridge is placed. In some cases — particularly when the failure was prosthetic (loose screw, fractured abutment) rather than biological — the existing implant may be salvageable and only the prosthetic components need replacement.
Not every failed implant case should get a new implant. Honesty about this matters: forcing a replacement into a site that won't sustain it produces a second failure.
If you've already had two or more implant failures at the same site, we evaluate whether the site is fundamentally unsuitable rather than placing a third implant. Sometimes a fixed bridge using adjacent teeth as abutments, or accepting the gap, is the more conservative path.
If the original failure has left insufficient bone for a replacement implant — and grafting alternatives aren't viable — we may recommend prosthetic alternatives.
If the original failure was driven by a medical factor that hasn't changed (uncontrolled diabetes, ongoing IV bisphosphonate therapy, etc.), placing a new implant before addressing that factor risks the same outcome.
Some patients, after a failed implant, prefer to move forward without trying again. We respect that decision and discuss prosthetic alternatives.
Each links to deeper detail on a treatment option or related clinical situation discussed above.
